Treating Infertility with Chinese Herbs

By Jake Paul Fratkin, OMD, LAc

Chinese medicine delineates several patterns in infertility. At its core, tonification of blood and kidney qi is necessary in most cases. Further pattern differentiation can be made for deficiency of kidney yang, yin or jing; liver qi stagnation, blood stasis, or accumulation of phlegm and dampness.

Frequent miscarriage often accompanies infertility, and in modern medicine is correlated with low levels of progesterone. The Chinese blood and kidney builders suggested here can boost progesterone levels. Some women with frequent miscarriage will benefit by combining Chinese herbal formulas with bioidentical progesterone. The best way to determine progesterone levels is by lab testing. After the age of 39, however, the viability of the woman's eggs come into question, and is a common reason for first-trimester miscarriage in older women. Chinese herbs cannot strengthen the life-force or integrity of the egg.

For fertility, the formulas described here boost blood and kidney qi. In cases with liver stagnation (irregularity, PMS), management requires addressing qi stagnation during the pre-menstrual phase, from ovulation until the first day of bleeding. A formula like Jia Wei Xiao Yao San is quite adequate. Then, a fertility blood tonic would be used at the end of menses until ovulation, or continued until the period starts. For cases with dysmenorrhea, it is important to use an appropriate formula starting either a day or so before cramping begins, or at least once cramping begins, and until cramping and clot expulsion is finished. Effective formulas include Tong Jing Wan or Shao Fu Zhu Yu Tang. In some patients, it may be necessary to work with three formulas: pre-menstrual, menstrual and post-menstrual.

Achieving a successful pregnancy may be quick, within one or two months, or prolonged over 6-8 months. The best sign of progress is that any menstrual problem becomes better and more normal. This particularly applies to irregular periods or amenorrhea. It is helpful to continue with blood tonics during the first trimester, to boost progesterone and prevent miscarriage. These formulas are also appropriate as post-partum tonics, and of course can be used for treating amenorrhea and irregular periods without fertility as a goal.

Of the 10 herbs in Fu Ke Zhong Zi Wan, the blood nourishing herbs make up 44% of the formula, and include shu di huang (23%) with dang gui, e jiao and bai shao. Du zhong and xu duan boosts kidney yang (21%), and xiang fu moves liver qi (12%). This is a common presentation in infertility, that is, blood and kidney deficiency with some liver stagnation.

Herbal Times has a Zhong Zi Wan, with a very different formula. Containing 18 herbs, the major herbal categories break down as follows: herbs to boost kidney (25%); herbs to move blood and break stasis (25%); herbs to tonify qi (17%); herbs to tonify blood (10%). This formula addresses infertility with a history of dysmenorrhea due to cold in the uterus, using the warm herbs tu si zi (Semen Cuscutae), xian mao (Rhizoma Curculiginis), xu duan (Radix Dipsaci), yin yang huo (Herba Epimedii) and lu rong (Cornu Cervi Pantotrichum). Due to the inclusion of ji xue teng (Caulis Spatholobi/Millettiae), the formula is technically prohibited during pregnancy, even though its application in the first trimester might be warranted.

This prescription treats infertility complicated by cold in the uterus. Warming herbs include wu zhu yu, gui zhi, gan jiang, e jiao and ren shen, and make up 33% of the formula, while warming blood-nourishing herbs make up 20% of the formula.

I treated a competition bicyclist for infertility. While reporting dysmenorrhea, her case was complicated by riding her bicycle during her menses in cold weather. This allowed cold to enter the uterus, and only by addressing the cold was the case able to resolve successfully.

The second version, Butiao Tablets, is a Chinatown patent medicine that addresses cold-damp accumulation in the uterus, with signs of watery spotting and cramps. It is an unusual and complex formula of 17 herbs, of which five are so uncommon that they are not listed in either Chen or Bensky. Its herbal ingredients can be categorized as follows: 25% to support kidney qi; 18% to dispel wind-damp; 15% to move blood and break stasis; 10% to tonify spleen qi; 9% to soothe liver qi; 8% to stop bleeding; and 4.5% to clear heat. Because it contains ji xue teng (Caulis Spatholobi/Millettiae), it is contraindicated during pregnancy.

This formula primarily tonifies blood (34%), supported by tonification of qi (20%), moving of blood (17%) and moving of qi (11%). The formula is often confused with Ren Shen Yang Rong Tang, which is a combination tonic of qi, blood, yin and yang. Yang Rong Wan is formulated for blood deficiency infertility, without containing any herbs that strengthen kidney yang.

These formulas offer a variety of approaches for addressing infertility. In straight up deficiency, most can be given throughout the month. When there is co-existing liver stagnation, adding in or substituting another formula for the two weeks prior to the period is helpful. In cases of menstrual cramping, adding in a formula during or before cramping is also necessary. My own success rate in infertility in woman under age 39, without structural complications such as fallopian tube fusing or endometriosis, is above 85%. Besides the formulas listed here, American companies offer a number of products that specifically address woman's fertility.

Comments are encouraged, but you must follow our User Agreement
Keep it civil and stay on topic. No profanity, vulgar, racist or hateful comments or personal attacks. Anyone who chooses to exercise poor judgement will be blocked. By posting your comment, you agree to allow MPA Media the right to republish your name and comment in additional MPA Media publications without any notification or payment.